Frank’s (2018) narrative overview analysis of connections between collective sex and HIV/STI risk explores an increasingly relevant societal issue: shifting the risk-focused dialogue around sexual behaviors to promote sexual health. Frank takes an inclusive analytic approach by uncovering parallels across academic disciplines to understand collective sexual behavior. Through this transdisciplinary analysis, she illuminates the ways in which a risk-centered approach for promoting sexual health falls short and collective sex is unwarrantedly linked with the spread of HIV/STIs. Ultimately, Frank’s thought-provoking path is likely to have researchers question their own positionality and opinions regarding collective sex (e.g., sex at swinger events, bathhouses, private events, rest areas) and HIV/STI risk. As Frank states:

Having sex intentionally in the presence of observers or with multiple partners is widely stigmatized, pathologized, and at times criminalized; places where collective sex occurs have long been policed in the name of the social order or morality, not just public health.

Through Frank’s analysis, a clear narrative emerges: one that highlights how researchers are designing studies and interpreting results filtered by the rose-tinted lens of monogamy. In this piece, I explore how the compulsion to view monogamy—dyadic sex in the context of an exclusive committed relationship—through an (unintentional) rose-tinted lens explains, in part, the inaccurate risk association between collective sex and the spread of HIV/STIs. Building on Frank’s vision for rethinking sexual risk, I draw on principles of feminist praxis and propose two ways in which researchers can engage in critical self-examination (reflexivity) to promote “healthy scientific advances.” My goal is to expand upon Frank’s analysis to further encourage researchers to consider their positionality and advance science aimed at HIV/STIs prevention.

Rose-Tinted Lens of Monogamy and Unwarranted Stigma of Consensually Non-Monogamous Behaviors and Relationships

Sexual intimacy is a central part of most people’s life experience. Expressions of sexuality that involve love, coupling, and reproduction are presumed to be optimal forms of partnering in Western society. As such, many people are motivated to defend a system of beliefs that posit: most people wish to couple, monogamy is enduring, and monogamy is the most important adult relationship. This system of beliefs is conceptualized as a committed relationship ideology (e.g., Day, 2016). Derogation of people who do not abide by these sexual norms is a consequence of a rigid ideological framework for how people should engage in sex and romance. This derogation further serves to idealize monogamy, creating a rose-tinted lens—an unduly idealistic, optimistic, and invulnerable perspective—through which people favor monogamy. Thus, the ability to engage in desired sex without cultural or medical persecution is a liberty for those who engage in monogamy, but not a liberty for all.

The tendency to view monogamy through a rose-tinted lens does not seem to be rooted in reality. In terms of relationship quality, monogamy does not invariably lead to greater satisfaction, commitment, love, or psychological health compared to polyamorous, open, and swinging relationships (Brewster et al., 2017; Conley, Matsick, Moors, & Ziegler, 2017; Conley et al., 2013b; Moors, Matsick, & Schechinger, 2017; Rubel & Bogaert, 2015). Focusing on sexual health, people engaged in consensually non-monogamous relationships are more likely to correctly and consistently use condoms, inform their partners of sexual experiences with others, and seek STI testing compared to people in ostensibly monogamous relationships (i.e., people also with multiple sexual partners, but are engaging in non-consensual non-monogamy; Conley, Moors, Ziegler, & Karathanasis, 2012).

Taken together, we exist within a broader sociopolitical system that idealizes monogamy. As such, subscription to a set of ideological beliefs that defend monogamy, even in the face of evidence that supports other types of relationships as viable options, transforms the way in which we view monogamy through rose-tinted lens. Given that researchers also exist and operate within a broader culture that idealizes monogamy, it would be challenging to believe that researchers are immune to a pro-monogamy bias. In the next section, I address ways that may help researchers move past the tendency to see monogamy through a rose-tinted lens.

Critical Self-Examination for (Sexually) Healthy Science: Two Points for Consideration

Sexual and romantic norms are rapidly evolving. Desire and engagement in consensual sex outside of a dyadic context appears to be on the rise (Moors, 2017; Scoats, Joseph, & Anderson, 2018; Sizemore & Olmstead, 2017). In fact, previous engagement in consensual non-monogamy is as mundane as domestic cat ownership: approximately 1 in 5 Americans have engaged in either lifestyle (Haupert, Moors, Gesselman, & Garcia, 2017b; Newport, Jones, Saad, & Carroll, 2006). Several scholars, including myself, Conley, Finkel, and Perel, have argued that we might be asking too much from our romantic and sexual partners: to be our best friends, confidants, therapists, and passionate lovers for decades (Conley & Moors, 2014; Finkel, Hui, Carswell, & Larson, 2014; Perel, 2006). The notion of having one person meet all of one’s sexual needs appears to be uncomfortable for many, and unrealistic for others. Yet, the dominant discourse around sexuality and sexual health (implicitly) prioritizes monogamy as the optimal way to engage in partnering and sex (Aguilar, 2013; Conley et al., 2015a; Moors et al., 2017). Thus, there is a disconnect between the ways in which sexual and romantic norms unfold in the real world and how they are conceptualized in research.

As Frank (2018) argues, shifting the dialogue around sexual health will open the door for new ways to think about HIV/STI prevention. Thus, how can researchers “rethink the unrelenting emphasis on risk?” (Frank, 2018). Dovetailing Frank’s future directions for HIV/STI prevention research, I propose two points of consideration for researchers to move toward promoting “healthy scientific advances:” (1) we should not expect to find a universal sexual experience and (2) we should question how we are asking questions and interpreting results. Grounded in feminist praxis (Cole, 2009; Harding, 1991; Stewart, 1998), these considerations are starting points for researchers to engage in critical self-examination regarding their research practices and (potential) pro-monogamy bias.

We Should not Expect to Find (or strive for) a Universalized Human Sexual Experience

In our society and in our science, monogamy is often portrayed as a universal desire (Conley et al., 2017; Moors et al., 2013). Some scientists seem to have a penchant for studying the human desire and conceptualizing theories that embody a unified experience. Yet, ample evidence runs contrary to the notion that monogamy is a universal desire and experience. As evidenced by the sheer volume of studies on collective sex—at clubs, swinger events, private parties, bathhouses—reviewed by Frank’s (2013, 2018) ongoing scholarship, multi-partnered and/or sequential partnered sex appears to be quite common. Moreover, several other descriptive markers suggest that monogamy is not desired by all. For instance, there is a commonplaceness of divorce (nearly one-half of U.S. marriages end in divorce; Copen, Daniels, Vespa, & Mosher, 2012), sexual infidelity (> 25% of people in monogamous relationships have engaged in non-consensual non-monogamy; Lehmiller, 2015), and engagement in consensually non-monogamous relationships (21% of people have engaged in some form of sexually open relationship during their life; Haupert, Gesselman, Moors, Fisher, & Garcia, 2017a).

Feminist scholars have critiqued the normative penchant of many scientists to seek a universal human experience. One way to enact self-examination is to recognize that individuals are shaped by experiences from multiple and conflicting subjective positions (Cole, 2009; Cole & Sabik, 2009; Stewart, 1998; Warner, 2008). As Frank (2018) discusses, various factors and positions (e.g., culture, personality, power, masculinity/femininity norms, context) affect the ways people perceive their sexual environment and sexual risk. Gaining a better understanding of sociocultural-structural sources that influence biological sources (and vice versa) will likely further complicate the notion of a universalized human sexual experience. It is not to say that studying long-term patterns of human behaviors is a useless research endeavor (see Brown, 1991). However, if universalism regarding sexual behavior is what researchers are seeking to find (with the exclusion of examining sociocultural factors), this line of inquiry will further limit our understanding of HIV/STI prevention.

As such, we should critically interrogate the theoretical frameworks that we employ. For example, have the findings from one group of people been interpreted to represent a universal or normative experience? Are we adequately examining nuanced variations across groups? And, how can we better incorporate multiple subjective positions? Sometimes universal experiences are captured in the form of parsimonious explanations. Cole (2009) suggests that searching for parsimonious explanations to complex social processes is often a pitfall of social science research. Moreover, the search for a parsimonious explanation is further demonstrated through using simplified statistical models, which hold constant (or control for) social identities often through the use of categorical variables, rather than measuring these identities with continuous variables or through non-quantitative methods (Warner, 2008). As such, we should also question the extent to which our analyses attempt to oversimplify complex systems of identity and sexual behaviors.

Following this logic, researchers should also not expect that there is a universal research framework that will help reduce the spread of HIV/STIs. A main conclusion of Frank’s (2018) analysis is that a risk-based approach to behavioral change is not the ideal framework for HIV/STI prevention research. Instead of a tendency to address risk through sexual behavior changes (e.g., reduce engagement in sex or specific sexual acts), Frank draws on the management of STIs through regular testing, treatment, and informing partners (as commonly practiced in the U.S. adult film industry; Grudzen & Kerndt, 2007). Moreover, as pointed out by Frank, rates of HIV/STI testing among people who engage in collective sex are high—remarkably high (> 80% reported being tested for HIV/STIs; e.g., Gama et al., 2017; Phillips, Grov, & Mustanski, 2015).

In line with Frank’s vision for rethinking risk, understanding the ability to navigate sexual health with multiple partners can greatly benefit HIV/STI prevention research. For instance, in one study of people engaged in multiple concurrent romantic and sexual relationships (specifically, polyamory), nearly all (91%) adhered to explicit sexual health rules, including routine STI testing (for all partners involved), and consistent use of barrier methods (Wosick-Correa, 2010). In a similar vein, some of my recent qualitative research examines how people engaged in multiple concurrent romantic/sexual relationships navigate their sexual health (current research in preliminary data phase). That is, what are the ways in which people are communicating about sexual health? In relation to people who are single and casually dating (i.e., multiple concurrent sexual partners), I found that people engaged in consensually non-monogamous relationships are displaying a wider array of HIV/STI prevention strategies. Specifically, people engaged in consensual non-monogamy frequently mention that they accompany their new sexual partner(s) to get an STI screen and/or share a copy of their most recent STI panel with a potential partner(s). In line with Frank’s vision, these preliminary results provide an avenue of future research ripe for exploration, namely the development of inclusive and sex-positive approach to sexual health.

We Should Question How We’re Asking Questions and Interpreting Results

One way for researchers to engage in self-examination is to question how we ask our research questions. For instance, how are we studying sexual activity? Are we preoccupied with finding high risk where risk is comparatively low (e.g., Conley, Moors, Matsick, & Ziegler, 2015b)? Are we (unintentionally) asking people to rank their identities, desires, or experiences? Through an intersectional feminist lens, Bowleg (2008) suggests to re-frame research questions so that participants are not expected to disaggregate their identities and contexts within the given question. That is, if a researcher poses a question that asks participants to rank or separately discuss their social identities (such as gender or sexual orientation) or experiences (such as sexual acts), a researcher will receive additive answers. For instance, what is the experience of being a man? A gay man? Someone who desires sex in public locations? Instead, Bowleg encourages researchers to pose intersectional questions that are about the interdependence of identities, experience, and context. For example, what is your experience as a gay man who desires sex in public locations? In this example, the re-framing does not parse apart the mutually constructive identities and context.

Throughout Frank’s (2018) analysis of collective sex and HIV/STI risk, she illuminates a pro-monogamy bias that many researchers—even those who study stigmatized sexualities—appear to hold. Understanding diverse intimate relationships and sexual behaviors is complicated because researchers appear to possess similar stereotypes as the public regarding monogamy. At several points, Frank provides insight (often in the form of direct quotes from original sources) that illustrates the ways in which researchers are overemphasizing the risk associated with collective and multiple-partnered sexual activity. For instance, Frank points out that a small study of swingers (12 participants in total) has been used to justify unwarranted claims, such as “many swingers choose not to use condoms consistently” (Bentzen & Træen, 2014). As Frank points out, a risk-focused approach to sexual health intervention often seeks to identify those who are “in need of intervention,” falsely assuming that swingers are “a ticking time bomb for STIs rather than a set of sexual recreational practices that has been evolving for at least half a century.” Thus, the rose-tinted lens that favors monogamy often subtly creeps into our interpretation of (otherwise straightforward) results. In a similar vein for self-examination recommendations, researchers can question whether their interpretation of results related to sex and the spread of HIV/STIs is overemphasized or overgeneralized.

Conclusion

A pro-monogamy bias—arguably, compulsory given the circumstances—that filters the ways in which researchers overestimate risk associated with collective sex and the spread of HIV/STIs seems undeniable. Building upon Frank’s (2018) inclusive analysis and practical insights, I proposed ways in which feminist praxis could provide a path for researchers to self-examine their scientific practices. Critically examining the ways in which we may be seeking to identify a universalized human sexual experience that does not unintentionally embed a pro-monogamy bias within our research may yield new areas for research on HIV/STI prevention. Or, at the very least, these considerations for self-examination are likely to produce less biased research. In agreement with Frank, the future of HIV/STI prevention research could greatly benefit from focusing on what we can learn from people who navigate sexual health with multiple concurrent partners—and a shift away from a sexual risk-focused paradigm.